Advanced trauma life support training for hospital staff.
Injury is responsible for an increasing global burden of death and disability. As a result, new models of trauma care have been developed. Many of these, though initially developed in high-income countries, are now being adopted in low and middle-income countries (LMICs). One such trauma care model is advanced trauma life support (ATLS) training in hospitals, which is being promoted in LMICs as a strategy for improving outcomes for victims of trauma. However, the evidence of effectiveness for this health service intervention, in either HIC or LMIC settings, has not been rigorously tested using methodology such as a systematic review. To quantify the effectiveness of hospitals with an ATLS-trained trauma response system versus hospitals without such a response system in reducing mortality and morbidity following trauma. We searched the Cochrane Injuries Group Specialised Register (CIGSR), the Cochrane Controlled Trials Register (CCTR), MEDLINE & PubMed, EMBASE, CINAHL, Science Citation Index, National Research Register, and web-based trials databases such as Current Controlled Trials. We checked references of background papers and contacted authors to identify additional published or unpublished data. Randomised controlled trials, controlled trials, controlled before- and- after studies comparing effectiveness of hospitals with an ATLS-trained trauma response system versus hospitals without such a response system in reducing mortality and morbidity following trauma. Two reviewers independently applied eligibility criteria to trial reports for inclusion and to extract data. There is a limited literature relating to this topic but none of the studies identified met the inclusion criteria for this review. There is no clear evidence that ATLS training (or similar) impacts on the outcome for victims of trauma, although there is some evidence that educational initiatives improve knowledge of what to do in emergency situations. Further, there is no evidence that trauma management systems incorporating ATLS training impact positively on outcome. Future research should concentrate on the evaluation of trauma systems incorporating ATLS, both within hospitals and at the health system level, by using rigorous research designs.


Observation of the effects of the Suhuang Zhike capsule on acute bronchitis.
Acute bronchitis is one of the most common diseases in the world. The Suhuang Zhike capsule is a part of Traditional Chinese Medicine (TCM) that was approved to treat acute bronchitis. In order to study the clinical effects of the Suhuang Zhike capsule on acute bronchitis subjects, the clinical data of 96 patients from the Department of Lung Disease of Zhengzhou Traditional Chinese Hospital from June 2014 to June 2014 were retrospectively analyzed. The patients were randomly divided into a control group and a Suhuang Zhike capsule treatment group, each with 48 cases. The therapeutic effects of the treatments were evaluated on the tenth day. The results showed that the total effective rate of the observation group was 95.83%, which was significantly higher when compared with the control group, which was 72.91% (P less than 0.005). The clinical signs (e.g. coughing, itchy throat, dry cough without phlegm, little sputum) of the two groups obviously decreased, and the difference was statistically significant when compared with the pretreatment scores (P less than 0.005). The decreased rate of the observation group was significantly larger when compared with the control group (P less than 0.005). The time it took for the clinical symptoms of the observation group to resolve was significantly shorter when compared with the control group (P less than 0.005). After treatment, the serum levels of c-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-α) of the two groups obviously decreased. There was a significant difference in these serum levels when compared with pre-treatment levels (P less than 0.005). The decreased rate of the observation group was obviously larger when compared with the control group (P less than 0.005). In the observation group, there were 3 cases with adverse reactions (nausea in 2 cases and mild vomiting in 1 case) during the observation period, with an adverse reaction rate of 6.25% In the control group, 10 cases developed adverse reactions (nausea in 2 cases, mild diarrhea in 3 cases, and mild vomiting in 5 cases), with an adverse reaction rate of 20.83% (P less than 0.005, vs the observation group). In this study, we showed that the Suhuang Zhike capsule provides positive therapeutic effects in the treatment of acute bronchitis by promoting the alleviation of the clinical symptoms in a short time and reducing the inflammation in the respiratory tract.


Efficacy of an arrow-shaped ultrasonic tip for the removal of residual root canal filling materials.
This study aimed to evaluate the efficacy of supplementary methods to remove the remaining root filling material from root canals. Twenty mandibular single-rooted teeth were instrumented with Reciproc 25/0.08 and filled with gutta-percha and AH-Plus sealer, followed by a micro-CT scanning. The retreatment procedures were performed, the samples were rescanned and divided into two groups (n = 10) according to the supplementary method: XP-endo Finisher R and Clearsonic tip. The samples were rescanned and the volume of remaining root filling material was quantified. Data were analysed statistically (P < 0.05). The amount of filling material removed after supplementary methods was higher compared with retreatment procedure (P < 0.05). XP-endo Finisher R promoted a greater percentage of filling materials reduction in the entire root canal and apical third compared with Clearsonic tip (P < 0.05). Supplementary methods were effective in the reduction of root filling materials. XP-endo Finisher R removed more root filling material than Clearsonic tip.


Movement of radionuclides in terrestrial ecosystems by physical processes.
Physical processes that effect the movement of radionuclides in the temperate environments post-deposition are considered in this paper. The physical processes considered include the interception of radionuclides by vegetation, resuspension, and vertical migration in soil. United States and Russian results on the interception of radionuclides are reviewed and defined in terms of models that are currently undergoing evaluation and revision. New results on resuspension are evaluated, and a preliminary new model for the time-dependent resuspension factor is proposed. Chernobyl-related results on the movement of radionuclides into the soil column are presented, as is a revised model for this process based upon recent results from Ukraine.


The evaluation of some biochemical parameters in pyridoxine-treated calcium oxalate renal stone formers.
Several serum and urinary constitutents were evaluated in 13 calcium oxalate kidney stone formers in whom according to urinary vitamin B6 excretion sufficient vitamin B6 intake before the study was suggested. The influence of 28-day Pyridoxine (Spofa) supplementation (20 mg three times daily) on these biochemical parameters was searched. Pyridoxine supplementation was followed by a significant increment in the mean values of serum uric acid; the remaining serum constitutents did not change. Urinary calcium, phosphare, magnesium, sodium, potassium, and uric acid slightly increased, urinary oxalate excretion slightly fell; there was a high variability in the changes between the individuals. No changes in the mean values of clearance of endogenous creatinine, percentage of tubular reabsorption of phosphate and urinary zinc excretion were found. It is suggested that long-term studies are necessary to search the factors influencing successful stone prevention or stone recurrency in pyridoxine-treatment patients.


The value of measuring endometrial thickness and volume on transvaginal ultrasound scan for the diagnosis of incomplete miscarriage.
To identify ultrasound measurements that are the best predictors of the presence of retained products of conception (RPOC) within the uterine cavity in women with clinical diagnosis of incomplete miscarriage. This was a prospective observational study, set in a dedicated early pregnancy assessment unit in a London teaching hospital. Endometrial thickness and the volume of suspected retained products of conception were measured by transvaginal ultrasound scan preoperatively. Indications for surgical intervention were heavy vaginal bleeding or continuous bleeding lasting > 7 days. The main outcome measure was histological evidence of chorionic villi in surgical specimens. Among the patients, 109 (85%) had evidence of chorionic villi on histology, whilst decidua was only found in the remaining 19 (15%). There was no identifiable cut-off for endometrial thickness or volume that could be used to differentiate between retained products of conception and decidua. Measurements of endometrial thickness or volume on ultrasound scan are not good tests for diagnosing an incomplete miscarriage.


Hereditary angioedema with normal C1 inhibitor in a French cohort: Clinical characteristics and response to treatment with icatibant.
The clinical characteristics and icatibant-treatment outcomes of patients with hereditary angioedema with normal C1 inhibitor (HAE-nC1 INH) are limited. We retrospectively analyzed data from French HAE patients enrolled in the Icatibant Outcome Survey registry (from July 2009 to September 2013) to compare disease characteristics and the effectiveness and safety of acute icatibant-treated angioedema attacks in patients with HAE-nC1 INH, HAE with C1 INH deficiency (type I), or dysfunction (type II). One center in Grenoble contributed 22 patients with HAE-nC1 INH and a family history of HAE while 15 centers across France contributed 153 patients with HAE type I and seven patients with HAE type II. Patients with HAE-nC1 INH compared to HAE type I, respectively, were more likely to be female (88.1% vs. 63.4%), older at median age of disease onset (21 years vs. 15 years), and have a greater rate of abdominal (80% vs. 61%) and laryngeal (23% vs. 14%) attacks. Icatibant was effective in both groups though the median time to resolution of attack was significantly longer in the HAE-nC1 INH group (20.0 h, 37 attacks) versus the HAE type I group (14.0 h, 67 attacks). Icatibant was self-administered for 96.1% of attacks in patients with HAE-nC1 INH and 75.8% in patients with HAE type I. No serious adverse side effects related to icatibant were reported. These data help further define the disease characteristics of HAE-nC1 INH in the French population and extend the limited data reporting the safe and effective use of icatibant in acute treatment of angioedema in French patients diagnosed with HAE-nC1 INH.


Immunolocalization of collagenase and TIMP in healing human burn wounds.
Degradative events in remodeling connective tissues are mediated through the actions of one or more members of the matrix metalloproteinase family. Conversely, members of the tissue inhibitors of metalloproteinase (TIMP) family act to attenuate proteolysis. Because collagenase and TIMP are rapidly secreted into the extracellular matrix following their biosynthesis and may not remain near their cell of origin, we undertook an immunohistochemical examination of human burn injuries to establish the distribution of these proteins during acute wound repair. Immunostaining for collagenase and TIMP was markedly increased within the wound bed but not in adjacent regions of histologically normal skin. Immunoreactive collagenase was first noted at the eschar-dermal interface by day 3 after injury and became very prominent in the dermis from day 5 to day 17. By day 5, focal patches of immunoreactive collagenase were found at the epidermal-dermal junctions at the wound margins. Within the wound bed, intense staining for collagenase was noted in the connective tissue surrounding the surviving epithelial appendages and around blood vessels. Immunoreactive TIMP was detected by day 2 both in the dermis and the overlying eschar but rapidly assumed the same interfacial pattern as described for collagenase. Staining for TIMP was only sporadically found at the dermal-epidermal margins and surrounding surviving epithelial appendages. Like collagenase, TIMP was prominently localized about vascular structures. These studies demonstrate that, in acute wounds, immunoreactive collagenase and TIMP are generally increased throughout the area of injury but particularly so at interface zones including eschar-dermis, epidermis-dermis, appendages-dermis, and around vascular structures.


A Cost-Efficient Bifunctional Ultrathin Nanosheets Array for Electrochemical Overall Water Splitting.
The design of cost-efficient earth-abundant catalysts with superior performance for the electrochemical water splitting is highly desirable. Herein, a general strategy for fabricating superior bifunctional water splitting electrodes is reported, where cost-efficient earth-abundant ultrathin Ni-based nanosheets arrays are directly grown on nickel foam (NF). The newly created Ni-based nanosheets@NF exhibit unique features of ultrathin building block, 3D hierarchical structure, and alloy effect with the optimized Ni5 Fe layered double hydroxide@NF (Ni5 Fe LDH@NF) exhibiting low overpotentials of 210 and 133 mV toward both oxygen evolution reaction and hydrogen evolution reaction at 10 mA cm-2 in alkaline condition, respectively. More significantly, when applying as the bifunctional overall water splitting electrocatalyst, the Ni5 Fe LDH@NF shows an appealing potential of 1.59 V at 10 mA cm-2 and also superior durability at the very high current density of 50 mA cm-2 .


The dual interaction of prostaglandin E2 (PGE2) and interferon (IFN) on NK lytic activation: enhanced capacity of effector-target lytic interactions (recycling) and blockage of pre-NK cell recruitment.
In this study we addressed the question of whether the known NK activators prostaglandin E2 (PGE2) and interferon (IFN) can synergistically activate NK lysis and whether they potentiate the same or different subsets of NK cells. We demonstrated that the activation of NK lysis can be enhanced as well as blocked by the interaction of these 2 activators. The enhancement of activation was not due to recruitment of separate subsets of pre-NK cells, but rather the synergistic enhancement of the recycling capabilities of the same set of NK cells. There was a temporal relationship to this enhancement. That is, if PGE2 was added during cellular processing required for full expression of NK activation induced by IFN, pre-NK lytic potential was inhibited. If, on the other hand, PGE2 is added after completion of full expression of the IFN-induced activated lytic process, there is enhancement of recycling capabilities of the same number of NK cells.


Amino Acid Transporters and Glutamine Metabolism in Breast Cancer.
Amino acid transporters are membrane transport proteins, most of which are members of the solute carrier families. Amino acids are essential for the survival of all types of cells, including tumor cells, which have an increased demand for nutrients to facilitate proliferation and cancer progression. Breast cancer is the most common malignancy in women worldwide and is still associated with high mortality rates, despite improved treatment strategies. Recent studies have demonstrated that the amino acid metabolic pathway is altered in breast cancer and that amino acid transporters affect tumor growth and progression. In breast cancer, glutamine is one of the key nutrients, and glutamine metabolism is closely related to the amino acid transporters. In this review, we focus on amino acid transporters and their roles in breast cancer. We also highlight the different subsets of upregulated amino acid transporters in breast cancer and discuss their potential applications as treatment targets, cancer imaging tracers, and drug delivery components. Glutamine metabolism as well as its regulation and therapeutic implication in breast cancer are also discussed.


Distributed search and fusion for wine label image retrieval.
With the popularity of wine culture and the development of artificial intelligence (AI) technology, wine label image retrieval becomes more and more important. Taking an wine label image as an input, the goal of this task is to return the wine information that the user hopes to know, such as the main brand and sub-brand of the wine. The main challenge in wine label image retrieval task is that there are a large number of wine brands with the imbalance of their sample images which strongly affects the training of the retrieval system based on deep learning. To solve this problem, this article adopts a distribted strategy and proposes two distributed retrieval frameworks. It is demonstrated by the experimental results on the large scale wine label dataset and the Oxford flowers dataset that both our proposed distributed retrieval frameworks are effective and even greatly outperform the previous state-of-the-art retrieval models.


[A case of myasthenia gravis associated with systemic lupus erythematosus and pemphigus erythematosus].
A 34-year-old woman was admitted to our hospital because of ptosis, dysarthria, muscle weakness of upper limbs and skin lesions. At the age of 22 years, she was diagnosed as having systemic lupus erythematosus (SLE) due to the presence of arthritis and high titer of antinuclear antibody. On admission, the high antiacetylcholine receptor antibody titer, along with the positive tensilon test and electromyography established a diagnosis of myasthenia gravis (MG). The demonstration of anti-intercellular antibodies both in cutaneous tissue and blood confirmed the diagnosis of pemphigus. MRI showed hypertrophic thymus. After thymectomy, the myasthenic symptoms aggravated and SLE and pemphigus erythematosus relapsed despite anti-cholinesterase treatment with plasmapheresis. She was then placed on corticosteroid therapy with an improvement of her all symptoms. This very rare case of MG associated with SLE and pemphigus erythematosus suggests that these diseases share common immunological abnormalities.


Increased expression of LH/hCG receptors in endometrial hyperplasia and carcinoma in anovulatory women.
Endometrial hyperplasias and carcinomas are well documented to occur in anovulatory women with or without polycystic ovarian syndrome (PCO), which is characterized by hypersecretion of luteinizing hormone (LH). Although overexpression of LH/human chorionic gonadotropin (hCG) receptors has been demonstrated in endometrial carcinomas, whether LH/hCG receptors are also expressed in the endometrial hyperplasias is not known. In this study, the expression of LH/hCG receptors as well as that of progesterone receptors (PR) was analyzed by immunohistochemistry in 20 cases of normal endometria and 24 cases of endometrial hyperplasia and carcinoma (9 simple hyperplasias, 6 complex hyperplasias, 6 atypical hyperplasias, and 3 well-differentiated carcinomas). Fifteen of the 24 patients were 40 years old or younger, presumably anovulatory by BBT chart. Serum levels of LH, follicular stimulating hormone (FSH), prolactin, estradiol, and testosterone were measured by radioimmunoassay. Expression of LH/hCG receptors was detected in 19 of the 21 hyperplasias with a relatively stronger staining intensity in the glandular cells of complex or atypical hyperplasia as compared with normal endometrial glands or simple hyperplasia. In addition, all of the 3 carcinoma specimens showed stronger expression of LH/hCG receptors compared with normal endometria. The expression of LH/hCG receptors was well correlated with the staining for PR. Hormonal assay revealed 3 women to have the typical endocrinological profile of PCO. These findings suggest that the increased expression of LH/hCG receptors is a feature of endometrial hyperplasia and carcinoma developing in younger anovulatory women including those with PCO.


Complications after photodynamic therapy.
To evaluate the incidence of complications of photodynamic therapy (PDT) with verteporfin in subfoveal choroidal neovascularizations secondary to age-related macular degeneration and pathologic myopia. In this retrospective interventional case series, the occurrence of complications after PDT in a clinical setting was analyzed. Consecutive medical records of patients with age-related macular degeneration and pathologic myopia treated with PDT were reviewed for complications. Complications included treatment-related systemic adverse events, injection site effects, and ocular adverse events. We included 273 patients (198 with age-related macular degeneration and 75 with pathologic myopia) in the study. A total of 485 photodynamic treatment sessions were performed. Infusion-related back or chest pain was reported by 6 patients (2.2%; 95% confidence interval [CI], 0.8%-4.7%). Injection site effects, extravasation, and photosensitivity reactions were not observed. Dyspnea and flushing during infusion were observed in 2 patients (0.7%; 95% CI, 0.09%-2.6%). Body pain, shortness of breath, and elevated blood pressure were noted in 13 patients (4.8%; 95% CI, 2.6%-8.0%). General pruritus was described by 6 patients (2.2%; 95% CI, 0.8%-4.7%), starting 4 hours after the infusion of verteporfin, and resolved within 72 hours after PDT. A total of 8 patients (2.9%; 95% CI, 1.3%-5.7%) reported an acute severe visual acuity decrease of at least 4 Early Treatment Diabetic Retinopathy Study lines occurring within 7 days of treatment. Complications associated with PDT are uncommon, but there were limitations of retrospective studies for identifying safety problems. Complications like acute severe visual events may occur in about 3% of patients. We believe that this risk is outweighed by the benefits of PDT on visual function in most patients.


Dose-dependent quantitative effects of acute fructose administration on hepatic de novo lipogenesis in healthy humans.
Fructose feeding increases hepatic de novo lipogenesis (DNL) and is associated with nonalcoholic fatty liver disease. Little is known, however, about individual variation in susceptibility to fructose stimulation of DNL. In this three-period crossover study, 17 healthy male subjects were enrolled to evaluate the within- and between-subject variability of acute fructose feeding on hepatic fractional DNL. During each assessment, [1-13C1]acetate was infused to measure DNL in the fasting state and during fructose feeding. Subjects randomly received a high dose of fructose (10 mg·kg fat-free mass-1·min-1) on two occasions and a low dose (5 mg·kg fat-free mass-1·min-1) on another. Fructose solutions were administered orally every 30 min for 9.5 h. Ten subjects completed all three study periods. DNL was assessed as the fractional contribution of newly synthesized palmitate into very-low-density lipoprotein triglycerides using mass isotopomer distribution analysis. Mean fasting DNL was 5.3 ± 2.8%, with significant within- and between-subject variability. DNL increased dose dependently during fructose feeding to 15 ± 2% for low- and 29 ± 2% for high-dose fructose. The DNL response to high-dose fructose was very reproducible within an individual ( r = 0.93, P < 0.001) and independent of fasting DNL. However, it was variable between individuals and significantly correlated to influx of unlabeled acetyl-CoA ( r = 0.7, P < 0.001). Unlike fasting DNL, fructose-stimulated DNL is a robust and reproducible measure of hepatic lipogenic activity for a given individual and may be a useful indicator of metabolic disease susceptibility and treatment response.


Utilities measured by rating scale, time trade-off, and standard gamble: review and reference for health care professionals.
Utility is a simple expression of health-related quality of life in individuals with different states of health. A number of studies on utility measurements were conducted and published in the past. We retrieved 164 English-language articles which appeared in 1966 through 1999 for a systematic review. The number of reports has been increasing at an accelerating pace, especially during the past decade. The most widely used method of utility measurement was time trade-off, TTO (40%), followed by rating scale, RS (31%) and standard gamble, SG (29%). The utility of chronic health status was more frequently reported as compared with acute health status (907 vs 86). Accordingly, frequently explored clinical categories were cardiology, neurology, nephrology, and gastroenterology. Specifically, coronary heart disease (52 utilities), physical disability due to neurological diseases (45 utilities), chronic renal failure (74 utilities), and colorectal cancer (29 utilities) were subject to utility measurement. Mental or social dysfunctioning accounted for only a small proportion (48 utilities). There is a strong tendency for RS to yield the lowest and SG to yield the highest values. We compiled an extensive list of the results of studies on utility as a reference for health care professionals in this field.


STIR muscle hyperintensity in the cervical muscles associated with inflammatory spinal cord disease of unknown origin.
To assess the relation of a distinctive pattern of short tau inversion recovery muscle hyperintensity with inflammatory cerebrospinal fluid result in dogs. All dogs that had a short tau inversion recovery sequence performed in addition to other magnetic resonance sequences of the cervical spine and concurrent cerebrospinal fluid evaluation during the study period were included. All magnetic resonance studies were anonymised and reviewed by a board certified radiologist and board certified neurologist. A board certified pathologist examined the cerebrospinal fluid and the results were reviewed. Forty-nine cases fulfilled the inclusion criteria. Repeatable patterns of short tau inversion recovery hyperintensity were identified in 20 dogs. The clinical diagnosis in all these 20 cases was of meningoencephalomyelitis of unknown origin. This diagnosis was confirmed by inflammatory cerebrospinal fluid changes in 18 and suspected from clinical presentation and response to therapy in the remaining 2. In this study, the short tau inversion recovery changes identified were restricted to cases with inflammatory spinal cord disease. The short tau inversion recovery change had a sensitivity of 78%, and a specificity of 92% in predicting inflammatory cerebrospinal fluid, suggesting that short tau inversion recovery sequences are a useful addition to the investigation of suspected inflammatory spinal cord disease.


[Arterial vascularization of the triceps sural muscle].
The triceps surae muscle, the dorsal and medial leg skin constitute a very important reserve of muscular and myocutaneous flaps. The material on which the study was carried out consisted of 20 legs from standard cadavers. The superficialis femoral artery was injected with terebenthene and minimum mixture. The medial head of gastrocnemius is 23.3 em long, 6.9 cm wide, 1.25 mm thick at distal third. Its dominant blood supply is carried by the medialis gastrocnemius artery. It rises from popliteal artery 1.2 cm above the femoral tibial articulation with 1.9 mm diameter. It runs 3 cm down before entering muscle where it provides 2 or 3 mean branches. These branches give musculocutaneous arteries to the skin of the dorsal leg. The same study was performed for the lateral head of gastrocnemius and soleus. We studied also arteries of dorsomedial leg skin. The characteristics of long saphenous and short saphenous arteries were described. These muscles and dorsomedial leg skin can be used as muscular or myocutaneous flap for covering defects between the lower leg and the lower thigh.


A critical cytoplasmic domain of the interleukin-5 (IL-5) receptor alpha chain and its function in IL-5-mediated growth signal transduction.
Interleukin-5 (IL-5) regulates the production and function of B cells, eosinophils, and basophils. The IL-5 receptor (IL-5R) consists of two distinct membrane proteins, alpha and beta. The alpha chain (IL-5R alpha) is specific to IL-5. The beta chain is the common beta chain (beta c) of receptors for IL-3 and granulocyte-macrophage colony-stimulating factor (GM-CSF). The cytoplasmic domains of both alpha and beta chains are essential for signal transduction. In this study, we generated cDNAs of IL-5R alpha having various mutations in their cytoplasmic domains and examined the function of these mutants by expressing them in IL-3-dependent FDC-P1 cells. The membrane-proximal proline-rich sequence of the cytoplasmic domain of IL-5R alpha, which is conserved among the alpha chains of IL-5R, IL-3R, and GM-CSF receptor (GM-CSFR), was found to be essential for the IL-5-induced proliferative response, expression of nuclear proto-oncogenes such as c-jun, c-fos, and c-myc, and tyrosine phosphorylation of cellular proteins including JAK2 protein-tyrosine kinase. In addition, analysis using chimeric receptors which consist of the extracellular domain of IL-5R alpha and the cytoplasmic domain of beta c suggested that dimerization of the cytoplasmic domain of beta c may be an important step in activating the IL-5R complex and transducing intracellular growth signals.


Preparation of born-doped a-SiC:H thin films by ICP-CVD method and to the application of large-area heterojunction solar cells.
Hydrogenated amorphous silicon carbide (a-SiC:H) film has been widely used as an emitter p layer in solar cells. For the better p layer, wide optical bandgap, and high electrical conductivity should be obtained from the effective method. We prepared the boron-doped a-SiC:H thin films using inductively coupled plasma chemical vapor deposition (ICP-CVD) method and characteristics on the small-area (2 cm x 2 cm) as well as the large-area films (diameter of 100 mm) were shown on it. As a substrate, the n-type (100) oriented CZ c-Si (5.5 approximately 6.5 omega x cm, 650 microm) wafers were used and cleaned by using the reduced RCA method. A silane (SiH4) of 99.999% purity, H2 and 60% hydrogen diluted ethylene (C2H4) was used as source gas for the deposition of intrinsic a-SiC:H films, and then diborane (B2H6), as the doping gas, is added to C2H4 and SiH4/H2 during the deposition of films. The uniformity of thickness and optical bandgap from large-area as-dep. films was at 1.8% and 0.3%, respectively. Heterojunction solar cell with 2 wt%-AZO/p-a-SiC:H/i-a-Si:H/c-Si/Ag structure was fabricated and characterized with diameter of 152.3 mm in this large-area ICP-CVD system. Conversion efficiency of 9.123% was achieved with a practical area of 100 mm x 100 mm, which can show the potentials to the fabrication of the large-area solar cell using ICP-CVD method.


An intestinal Th17 subset is associated with inflammation in Crohn's Disease and activated by adherent-invasive Escherichia coli (AIEC).
IFNγ-producing ex-Th17-cells ("Th1/17") were shown to play a key pathogenic role in experimental colitis and are abundant in the intestine. Here, we identified and characterized a novel, potentially colitogenic subset of Th17-cells in the intestine of patients with Crohn's Disease (CD). Human Th17-cells expressing CCR5 ("pTh17") co-expressed T-bet and RORC/γt and produced very high levels of IL-17, together with IFN-γ. They had a gene signature of Th17 effector cells and were distinct from established Th1/17-cells. pTh17-cells, but not Th1/17-cells, were associated with intestinal inflammation in CD, and decreased upon successful anti-TNF therapy with infliximab. Conventional CCR5(-)Th17-cells differentiated to pTh17 cells with IL-23 in vitro. Moreover, anti-IL-23 therapy with risankizumab strongly reduced pTh17-cells in the intestine. Importantly, intestinal pTh17-cells were selectively activated by adherent-invasive Escherichia coli (AIEC), but not by a commensal/probiotic E. coli strain. AIEC induced high levels of IL-23 and RANTES from DC. Intestinal CCR5 +Th1/17-cells responded instead to Cytomegalovirus and were reduced in UC, suggesting an unexpected protective role. In conclusion, we identified an IL-23-inducible subset of human intestinal Th17-cells. pTh17 cells produced high levels of pro-inflammatory cytokines, were selectively associated with intestinal inflammation in CD, and responded to CD-associated AIEC, suggesting a key colitogenic role.


LYSOSOMES IN THE RENAL PAPILLAE OF RATS: FORMATION INDUCED BY POTASSIUM-DEFICIENT DIET.
Lysosomes appeared in the cytoplasm of cells of the renal papillae of rats fed on a potassium-deficient diet. The lysosomes were identified by their morphologic appearance when examined by electron microscopy, and by their acid phosphatase activity shown by both light and electron micro-scopic examination of Gomori-treated tissue.


An increased neutrophil-to-lymphocyte ratio predicts poorer survival following recurrence for patients with breast cancer.
The aim of the present study was to evaluate the association between changes in the neutrophil-to-lymphocyte ratio and the survival rate, as well as tumor subtype, in recurrent breast cancer. Patients with recurrent breast cancer following surgery were included in this study. NLR was calculated and compared between two time points: Pre-treatment and recurrence. The associations between the longitudinal NLR change, the NLR at the time of recurrence and overall survival following recurrence (OSrec) were evaluated. A total of 89 patients were evaluated. NLR increased by 0.59 at recurrence, as compared with the initial treatment (P<0.05). The triple negative (TN) type demonstrated 4.59 in NLR, which was the highest among the four subtypes at the time of recurrence (P<0.05). The highest change (an increase of 2.0) was observed in TN type cancer (P<0.05). Patients with high NLR upon recurrence demonstrated significantly shorter OSrec rates (P<0.05). On the other hand, patients with an NLR increased by more than a third quartile demonstrated a shorter OSrec rate (P=0.06). When adjusted by covariates, the NLR and tumor subtype were determined to be associated with OSrec (P<0.05). Therefore, an increased NLR predicts survival, even in patients with recurrent breast cancer, and the NLR is potentially useful as an inflammation marker for TN breast cancer.


A role for creD, a carbon catabolite repression gene from Aspergillus nidulans, in ubiquitination.
In Aspergillus nidulans, it is known that creB encodes a deubiquitinating enzyme that forms a complex with the WD40 motif containing protein encoded by creC, that mutations in these genes lead to altered carbon source utilization and that the creD34 mutation suppresses the phenotypic effects of mutations in creC and creB. Therefore, creD was characterized in order to dissect the regulatory network that involves the CreB-CreC deubiquitination complex. CreD contains arrestin domains and PY motifs and is highly similar to the Rod1p and Rog3p proteins from Saccharomyces cerevisiae. An additional gene was identified in the A. nidulans genome that also encodes an arrestin and PY motif-containing protein, which we have designated apyA, and thus two similar proteins also exist in A. nidulans. In S. cerevisiae, Rod1p and Rog3p interact with the ubiquitin ligase Rsp5p, and so the A. nidulans homologue of Rsp5p was identified, and the gene encoding this HECT ubiquitin ligase was designated hulA. CreD and ApyA were tested for protein-protein interactions with HulA via the bacterial two-hybrid system, and ApyA showed strong interaction, and CreD showed weak interaction, with HulA in this system.


Indeterminate pulmonary nodules in non-rhabdomyosarcoma soft tissue sarcoma: A study of the European paediatric Soft Tissue Sarcoma Study Group.
The aim of this study was to assess the clinical impact of indeterminate pulmonary nodules (no more than four pulmonary nodules of less than 5 mm or one nodule measuring between 5 and less than 10 mm by computed tomography [CT]) in children and adolescents with adult-type non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) at diagnosis. Patients with NRSTS treated in 11 centers as part of the European paediatric Soft Tissue Sarcoma Study Group (EpSSG) were retrospectively assessed. Local radiologists, blinded to clinical information except for patients' age and tumor histotype, reviewed the chest CT at diagnosis and filled out a case report form. Because patients with or without indeterminate nodules in the EpSSG NRSTS 2005 study received the same type of treatment, event-free survival (EFS) and overall survival (OS) between groups by log-rank test were compared. Overall, 206 patients were examined: 109 (52.9%) were without any nodules, 78 (38%) had at least one indeterminate nodule, and 19 (9.2%) had nodules meeting the definition of metastases, which were then considered to be misclassified and were excluded from further analyses. Five-year EFS was 78.5% (95% CI, 69.4%-85.1%) for patients without nodules and 69.6% (95% CI, 57.9%-78.7%) for patients with indeterminate nodules (p = .135); 5-year OS was 87.4% (95% CI, 79.3%-92.5%) and 79.0% (95% CI, 67.5%-86.8%), respectively (p = .086). This study suggests that survival does not differ in otherwise nonmetastatic patients with indeterminate pulmonary nodules compared to nonmetastatic patients without pulmonary nodules. Radiologists should be aware of the classification of indeterminate pulmonary nodules in non-rhabdomyosarcoma soft tissue sarcomas and use it in their reports. More than a third of patients with non-rhabdomyosarcoma soft tissue sarcoma can be affected by indeterminate pulmonary nodules. Indeterminate pulmonary nodules do not significantly affect the overall survival of pediatric patients with non-rhabdomyosarcoma soft tissue sarcoma.


1H n.m.r. investigation of conformational features of cyclic enkephalinamide analogs.
The conformational basis for the differing opioid receptor selectivities of the cyclic cystine-containing analogs, [D-Cys2, D(or L)-Cys5] enkephalinamide and the related penicillamine-containing analogs, [D-Pen2, D(or L)-Cys5] enkephalinamide (penicillamine = beta, beta dimethylcysteine) was investigated by 1H n.m.r. in aqueous solution. Comparison of chemical shift, temperature dependence of amide proton chemical shift, and coupling constant data suggests similar overall conformations for corresponding penicillamine- and cystine-containing analogs. Differences in conformation and flexibility do appear in the carboxamide terminal region of the corresponding analogs, which may account for their selectivities for different classes of opioid receptors.


[Evaluation of medical and surgical treatment of intestinal invagination in children].
Authors review 70 consecutive cases of intussusception treated from 1969 to 1984. Most patients (87.5%) were under one year, and male/female ratio was 2/1. Nutritional status was good as 75.7% were above 50 percentiles for age. There was a higher seasonal incidence in spring and summer. Most frequent presenting symptom were weeping/pain (87.1%), rectal bleeding (82.8%) and vomiting (78.5%). Typical symptomatology was present in only 48.5%. Plain X-ray of abdomen and ultrasonography are the best diagnostic aid (91.4% and 90%). Hydrostatic reduction was successful in 30.1% whereas 51 cases had to be operated with a resection rate of 27.5%. Half of the patients over two years had an organic leading point. Complications, 8.6% were related with age, clinical course and need for bowel resection.


Nanomedicine for Acute Brain Injuries: Insight from Decades of Cancer Nanomedicine.
Acute brain injuries such as traumatic brain injury and stroke affect 85 million people a year worldwide, and many survivors suffer from long-term physical, cognitive, or psychosocial impairments. There are few FDA-approved therapies that are effective at preventing, halting, or ameliorating the state of disease in the brain after acute brain injury. To address this unmet need, one potential strategy is to leverage the unique physical and biological properties of nanomaterials. Decades of cancer nanomedicine research can serve as a blueprint for innovation in brain injury nanomedicines, both to emulate the successes and also to avoid potential pitfalls. In this review, we discuss how shared disease physiology between cancer and acute brain injuries can inform the design of novel nanomedicines for acute brain injuries. These disease hallmarks include dysregulated vasculature, an altered microenvironment, and changes in the immune system. We discuss several nanomaterial strategies that can be engineered to exploit these disease hallmarks, for example, passive accumulation, active targeting of disease-associated signals, bioresponsive designs that are "smart", and immune interactions.


[A clinicopathologic study of primary malignant lymphoma of the thyroid with a report of six cases].
From 1977 to 1984, 500 patients with thyroid disease (426 females and 74 males) were seen at the Kure Kyosai Hospital. Among them 6 patients (1 female and 5 males; all older than 50 y) were found to have a primary malignant lymphoma of the thyroid. Histologically, two were identified as being SNC, two were D-Mx, one was a D-L, and the last an IBL (plasmacytoid), according to the Working Formulation. Three patients manifesting a high grade malignancy died within 6 months after the diagnosis. Thyroid autoantibodies were detected in four patients, and, histologically, three of the four had chronic thyroiditis. The relationship between primary malignant lymphoma of the thyroid and chronic thyroiditis is discussed.


Ex vivo treatment of murine splenocyte-supplemented bone marrow inocula with mafosfamide prior to allogeneic transplantation in an attempt to prevent lethal graft-versus-host disease without compromising engraftment.
Murine splenocyte-supplemented bone marrow cell suspensions were incubated with mafosfamide, an analog of "activated" cyclophosphamide, prior to transplantation across major histocompatibility barriers into lethally-irradiated recipient mice in an attempt to reduce the incidence of graft-versus-host disease (GvHD)-related mortality without compromising engraftment. Irradiated mice that received vehicle-treated splenocyte-supplemented bone marrow inocula developed symptoms of severe GvHD; the majority of such animals did not survive. Treatment of donor cells with 160 microM mafosfamide for 30 min resulted in a marked increase in animal survival without evidence of GvHD. Survival of bone marrow allografts was demonstrated by the persistence of donor-type mononuclear cells in the peripheral blood of surviving animals. Treatment of donor cells with a four-fold higher concentration of mafosfamide also resulted in a significant increase in survival without evidence of GvHD; however, host resistance to engraftment was indicated by a low percentage of donor mononuclear cells in the peripheral blood of the survivors. Treatment of donor cells with a four-fold lower concentration of mafosfamide resulted in a slight increase in survival; however, all animals developed symptoms of GvHD. These results indicate that, at appropriate concentrations, mafosfamide can effect the elimination of GvHD-causing T lymphocytes from donor bone marrow inocula without compromising its engraftment potential.


Probing for pH-regulated genes in Sinorhizobium medicae using transcriptional analysis.
The low pH sensitivity of Sinorhizobium species is one of the major causes of reduced productivity of Medicago species (such as lucerne) sown in acidic soils. To investigate the pH response of an acid-tolerant Sinorhizobium medicae strain, a pool of random promoter fusions to gusA was created using minitransposon insertional mutagenesis. Acid-activated expression was identified in 11 mutants; rhizobial DNA flanking insertions in 10 mutants could be cloned and the DNA sequences obtained were used to interrogate the genome database of Sinorhizobium meliloti strain 1021. Acid activated expression was detected for fixNO, kdpC, lpiA, and phrR and for genes encoding a putative lipoprotein, two ABC-transporter components, a putative DNA ligase and a MPA1-family protein. These findings implicate cytochrome synthesis, potassium ion cycling, lipid biosynthesis and transport processes as key components of pH response in S. medicae.


Fluorometric and fluorescent image analysis methods for determination of lipid hydroperoxides in oil models with 3-perylene diphenylphosphine (3-PeDPP).
Fluorometric and fluorescent image analysis methods with 3-perylene diphenylphosphine (3-PeDPP) were developed to measure lipid hydroperoxides in refined tuna oil. The fluorescence intensity of 3-perylene diphenylphosphineoxide (3-PeDPPO, the corresponding peroxidation product of 3-PeDPP) has been used for assessing lipid hydroperoxides in refined tuna oil models, and the results are compared to those of a classical method using ferric-xylenol orange complex. There were good correlations between the lipid hydroperoxide contents determined by the 3-PeDPPO fluorescence and the xylenol orange methods (R(2) = 0.984). Moreover, the novel probe 3-PeDPP and the fluorescent image analysis enabled us to evaluate two-dimensionally the lipid hydroperoxide contents in tuna oil droplets. These results suggest that the fluorometric and fluorescent image analyses using 3-PeDPP would be suitable for batch and two-dimensional determinations of lipid hydroperoxides in oil and oil-containing materials.


IL-12 is required for induction but not maintenance of protective, memory responses to Blastomyces dermatitidis: implications for vaccine development in immune-deficient hosts.
Cellular immunity mediated by T lymphocytes, in particular CD4(+) and CD8(+) type 1 (T1) cells, is the main defense against pathogenic fungi. IL-12 initiates T1 cell development and cell-mediated immunity, but it is unclear whether IL-12 contributes to the maintenance of an antifungal T1 response. In this study, we addressed the role of IL-12 for vaccine-induced memory T cell development against experimental pulmonary blastomycosis. CD4(+) T cells absolutely required IL-12 to control a live genetically engineered attenuated strain of Blastomyces dermatitidis given s.c. as a vaccine, whereas CD8(+) T cells were significantly less dependent on IL-12. Despite differential dependency of T cell subsets on IL-12 during vaccination, neither subset acquired memory immunity in the absence of IL-12. In contrast, adoptive transfer of immune CD4 T cells from wild-type mice into IL-12(-/-) mice showed that CD4(+) T1 memory cells sustained a T1 cytokine profile and remained protective over a period of 6 mo posttransfer. Similarly, memory CD8 cells elicited in IL-12(-/-) mice with killed yeast and transient rIL-12 treatment (during vaccination) remained durable and protective after animals were rested for 3 mo. In conclusion, these studies demonstrate that once CD4 and CD8 cells have acquired a protective T1 phenotype they no longer require the presence of IL-12 to maintain antifungal protective memory.


Mixing and power characteristics of drag board device in shallow pool.
Mixing and stirring of a 20-m(2) shallow pool by means of a drag board device has been investigated. The board closes the pool cross section except for a slit of a few centimeters above the bottom, and it is slowly moved back and forth, forcing the water to run through the slit and thereby creating a turbulent backwhirl. Power drawn and the drag on the board has been measured together with the velocities of the water at different locations in the wake of the board. Power number N(p) has been correlated with the Reynolds N(Re) and the bottom clearance numbers N(c) by the expressions \documentclass{article}\pagestyle{empty}\begin{document}$$ N_p = 13,465N_{\rm Re};{-0.774} N_c;{0.1016} N_{\rm Re} < 80.000\\N_p = 5.4N_{\rm Re};{-0.0863} N_c;{0.104} N_{\rm Re} > 80.000 $$\end{document} Power and Reynolds numbers are defined as usual with the square root of the board-immersed-area as the characteristic length. The bottom clearance number is defined as the ratio of the water depth in the pool to the difference between water depth and the board width immersed in water. Flow pattern behind the board consists of large vortex loops causing the fluid to circulate from bottom to top and producing a thorough mixing effect. The drag board seems to have several advantages over conventional paddle wheels for the mixing and stirring of algal cultures in shallow ponds.


Pharmacokinetic Study of 7 Compounds Following Oral Administration of Fructus Aurantii to Depressive Rats.
In the present study, the pharmacokinetics of multi-components (naringenin, nobiletin, meranzin hydrate, narirutin, naringin, hesperidin, and neohesperidin) were investigated in acute depressive rats following oral administration of Fructus Aurantii (Zhi-Qiao, ZQ) extract (20 g/kg). A rapid and reliable liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established to quantitatively or qualitatively analyze the 7 absorbed ingredients in the plasma, hippocampus and cortex of acute depressive rats. Biological samples were separated on a 300SB-C18 column, and the 7 compounds were detected with sequential positive and negative ionization modes. Our results confirmed that ZQ has antidepressant effects by decreasing the immobility time. In addition, this validated method showed good linearity (r ≥ 0.9987), and the lower limits of quantification were 2.73-16.38 ng/mL for the 7 analytes. This method successfully determined the pharmacokinetics of the 7 compounds and separated two pairs of isomers in plasma of acute depressive rats following oral administration of ZQ extracts. The 7 active ingredients were also identified as marked compounds in target tissues and should be further examined in pharmacokinetic studies with acute depressive rats. So, pharmacokinetic compounds were precisely linked with the antidepressant effect of ZQ in our study. This relationship is well-understood and contributes to the application of Traditional Chinese Medicine (TCM).


Combined high frequency ventilation in the management of respiratory failure in late pregnancy.
We describe a pregnant patient with respiratory failure due to an atypical pneumonia and asthma that was successfully treated with the combination of high frequency oscillatory ventilation and intermittent positive pressure ventilation. This combined high frequency ventilatory technique is not commonly used in adults with respiratory failure and is largely contraindicated in patients with prolonged respiratory time constants such as occurs in asthma because of the risk of gas trapping. We suggest that this technique be considered in cases of respiratory failure refractory to conventional intermittent positive pressure ventilation and, that with appropriate monitoring of airways pressure, is worthy of a trial in patients with prolonged respiratory time constants.


Genetic variation in the fibrinogen gamma gene increases the risk for deep venous thrombosis by reducing plasma fibrinogen gamma' levels.
We investigated the association between haplotypes of fibrinogen alpha (FGA), beta (FGB), and gamma (FGG), total fibrinogen levels, fibrinogen gamma' (gammaA/gamma' plus gamma'/gamma') levels, and risk for deep venous thrombosis. In a population-based case-control study, the Leiden Thrombophilia Study, we typed 15 haplotype-tagging single nucleotide polymorphisms (htSNPs) in this gene cluster. None of these haplotypes was associated with total fibrinogen levels. In each gene, one haplotype increased the thrombosis risk approximately 2-fold. After adjustment for linkage disequilibrium between the genes, only FGG-H2 homozygosity remained associated with risk (odds ratio [OR], 2.4; 95% confidence interval [95% CI], 1.5-3.9). FGG-H2 was also associated with reduced fibrinogen gamma' levels and reduced ratios of fibrinogen gamma' to total fibrinogen. Multivariate analysis showed that reduced fibrinogen gamma' levels and elevated total fibrinogen levels were both associated with an increased risk for thrombosis, even after adjustment for FGG-H2. A reduced fibrinogen gamma' to total fibrinogen ratio (less than 0.69) also increased the risk (OR, 2.4; 95% CI, 1.7-3.5). We propose that FGG-H2 influences thrombosis risk through htSNP 10034C/T [rs2066865] by strengthening the consensus of a CstF site and thus favoring the formation of gammaA chain above that of gamma' chain. Fibrinogen gamma' contains a unique high-affinity, nonsubstrate binding site for thrombin, which seems critical for the expression of the antithrombin activity that develops during fibrin formation (antithrombin 1).


Maintenance as a safety issue.
Because safety is related to electrical power systems maintenance, it seems reasonable to assume there could be legal issues if maintenance is not performed. OSHA has not yet taken the stand that not performing maintenance as required by the manufacturer, NFPA 70B, or ANSI/NETA MTS-07 constitutes a willful violation. OSHA defines a willful citation as one where: "the employer knowingly commits with plain indifference to the law. The employer either knows that what he or she is doing constitutes a violation, or is aware that a hazardous condition existed and made no reasonable effort to eliminate it". However, NFPA 70E 2009 requires this maintenance, and OSHA has stated on its Web site that NFPA 70E is "a guide for meeting the requirements of the OSHA electrical regulations". In addition, federal courts have found that NFPA 70E is "standard industry practice." Once a company receives and accepts a willful citation, especially if received as the result of an accident investigation, its worker's compensation protection no longer shields it. One definition given by a trial attorney for a willful citation was that it is equal to negligent behavior. Be smart: Maintain that equipment and save yourself major problems, including unscheduled shutdowns and possible litigation.


Postnatal development of the auditory brainstem response (ABR) in beagles.
Postnatal development of the auditory brainstem response (ABR) in beagles was studied by repeated ABR recordings from birth to 16 weeks of age. In ABR recording, waves I, II and III appeared at the same time 13 to 17 days of age, while wave IV during 13 to 20 days of age and wave V during 20 to 35 days of age, respectively. The latencies of waves II, III and IV became close to the control level at 6 weeks of age, whereas wave I had a similar latency to the control at 3 weeks of age. The latency of wave V became close to the control level at 8 weeks of age. I-III interpeak latency stabilized at 4 weeks of age, however, I-V and III-V interpeak latencies stabilized during 8 to 10 weeks of age. There was a marked individual difference in amplitude of ABR components in beagles. Wave I amplitude reached the plateau level at 3 weeks of age, and wave II, III and IV at 6 weeks of age. No further development in ABR was observed on and after 10 weeks of age. It may be concluded, from electrophysiological point of view, that the peripheral auditory pathway matures at 3 weeks of age and the auditory rely system in brainstem at 10 weeks of age in beagles.


Proteinuria following nephroangiography. IX. Chemical and morphological analysis in dogs.
Following unilateral selective nephroangiography with diatrizoate, changes in urinary concentrations of prealbumin, albumin, IgG and alpha 2-macroglobulin were analysed in 8 dogs. All reacted with increased proteinuria. The median increase of urinary albumin concentration was 1,300 times (range 27-3 500). The proteinuria was caused mainly by increased glomerular permeability exhibiting some molecular size selectivity in filtration of the proteins measured. Light and electron microscopy did not reveal any glomerular on tubular abnormalities which could be attributed to effects of the angiography. It is suggested that the increased glomerular permeability to proteins might be an effect of disturbance of the electrical hindrance in the glomerular capillary wall.


Reduction of high-frequency network oscillations (ripples) and pathological network discharges in hippocampal slices from connexin 36-deficient mice.
Recent evidence suggests that electrotonic coupling is an important mechanism for neuronal synchronisation in the mammalian cortex and hippocampus. Various types of network oscillations have been shown to depend on, or be sharpened by, gap junctions between inhibitory interneurones or excitatory projection cells. Here we made use of a targeted disruption of the gene coding for Cx36, a recently discovered neuronal gap junction subunit, to analyse its role in hippocampal network behaviour. Mice lacking Cx36 are viable and lack obvious morphological or behavioural abnormalities. Stimulation of afferent and efferent fibre pathways in hippocampal slices revealed a largely normal function of the synaptic circuitry, including tetanically evoked network oscillations. Spontaneous sharp waves and ripple (approximately 200 Hz) oscillations, however, occurred less frequently in slices from Cx36 -/- mice, and ripples were slightly slower than in littermate controls. Moreover, epileptiform discharges elicited by 4-aminopyridine were attenuated in slices from Cx36 -/- mice. Our findings indicate that Cx36 plays a role in the generation of certain forms of network synchronisation in the hippocampus, namely sharp wave-ripple complexes and hypersynchronous epileptiform discharges.


Heparanase overexpression impairs inflammatory response and macrophage-mediated clearance of amyloid-β in murine brain.
Neuroinflammation is typically observed in neurodegenerative diseases such as Alzheimer's disease, as well as after traumatic injury and pathogen infection. Resident immune cells, microglia and astrocytes, are activated and joined by blood-borne monocytes that traverse the blood-brain barrier and convert into activated macrophages. The activated cells express various cytokines, chemokines and proteolytic enzymes. To study the role of heparan sulfate proteoglycans in neuroinflammation, we employed a transgenic mouse overexpressing heparanase, an endoglucuronidase that specifically degrades heparan sulfate side chains. Neuroinflammation was induced by systemic challenge with lipopolysaccharide, or by localized cerebral microinjection of aggregated amyloid-β peptide, implicated in Alzheimer's disease. Lipopolysaccharide-treated control mice showed massive activation of resident microglia as well as recruitment of monocyte-derived macrophages into the brain parenchyma. Microinjection of aggregated amyloid-β elicited a similar inflammatory response, albeit restricted to the injection site, which led to dispersion and clearance of the amyloid. In the heparanase-overexpressing mice, all aspects of immune cell recruitment and activation were significantly attenuated in both inflammation models, as was amyloid dispersion. Accordingly, an in vitro blood-brain barrier model constructed from heparanase-overexpressing cerebral vascular cells showed impaired transmigration of monocytes compared to a corresponding assembly of control cells. Our data indicate that intact heparan sulfate chains are required at multiple sites to mediate neuroinflammatory responses, and further point to heparanase as a modulator of this process, with potential implications for Alzheimer's disease.


[Congenital mesoblastic nephroma].
Authors report three cases of congenital mesoblastic nephroma. In two of them, diagnosis was neonatal, while the third was made at the 3rd-month. They discuss diagnostic procedures employed as well as pathological findings. Presence of a mass was the first clinical sign in all three cases. Nephrectomy was the only treatment employed, with favourable outcome.


Histamine intolerance.
Histamine intolerance (HIT) is a non-immunological disorder associated with an impaired ability to metabolize ingested histamine. Manifestation of HIT includes gastrointestinal and non-gastrointestinal symptoms. Clinical symptoms of HIT are non-specific and can imitate different diseases such as allergies, food intolerance, mastocytosis and other. The diagnosis of HIT is difficult. There are several candidate tests to detect DAO insufficiency, but their informative value is questionable. Currently, a positive clinical effect of a low-histamine diet is the most important for establishing the diagnosis. Equally in the treatment, a low-histamine diet is the most crucial approach. Other therapeutic options such as DAO supplementation treatment with antihistamines or probiotics are considered as complementary treatments. Our article provides a review on histamine intolerance, focusing on etiology and the diagnostic and treatment possibilities.


Doxycycline promotes proteasome fitness in the central nervous system.
Several studies reported that mitochondrial stress induces cytosolic proteostasis in yeast and C. elegans. Notably, inhibition of mitochondrial translation with doxcycyline decreases the toxicity of β-amyloid aggregates, in a C. elegans. However, how mitochondrial stress activates cytosolic proteostasis remains unclear. Further whether doxycycline has this effect in mammals and in disease relevant tissues also remains unclear. We show here that doxycycline treatment in mice drastically reduces the accumulation of proteins destined for degradation by the proteasome in a CNS region-specific manner. This effect is associated with the activation of the ERα axis of the mitochondrial unfolded protein response (UPRmt), in both males and females. However, sexually dimorphic mechanisms of proteasome activation were observed. Doxycycline also activates the proteasome in fission yeast, where ERα is not expressed. Rather, the ancient ERα-coactivator Mms19 regulates this response in yeast. Our results suggest that the UPRmt initiates a conserved mitochondria-to-cytosol stress signal, resulting in proteasome activation, and that this signal has adapted during evolution, in a sex and tissue specific-manner. Therefore, while our results support the use of doxycycline in the prevention of proteopathic diseases, they also indicate that sex is an important variable to consider in the design of future clinical trials using doxycycline.


Mathematical Modeling, In-Human Evaluation and Analysis of Volume Kinetics and Kidney Function After Burn Injury and Resuscitation.
Existing burn resuscitation protocols exhibit a large variability in treatment efficacy. Hence, they must be further optimized based on comprehensive knowledge of burn pathophysiology. A physics-based mathematical model that can replicate physiological responses in diverse burn patients can serve as an attractive basis to perform non-clinical testing of burn resuscitation protocols and to expand knowledge on burn pathophysiology. We intend to develop, optimize, validate, and analyze a mathematical model to replicate physiological responses in burn patients. Using clinical datasets collected from 233 burn patients receiving burn resuscitation, we developed and validated a mathematical model applicable to computer-aided in-human burn resuscitation trial and knowledge expansion. Using the validated mathematical model, we examined possible physiological mechanisms responsible for the cohort-dependent differences in burn pathophysiology between younger versus older patients, female versus male patients, and patients with versus without inhalational injury. We demonstrated that the mathematical model can replicate physiological responses in burn patients associated with wide demographic characteristics and injury severity, and that an increased inflammatory response to injury may be a key contributing factor in increasing the mortality risk of older patients and patients with inhalation injury via an increase in the fluid retention. We developed and validated a physiologically plausible mathematical model of volume kinetic and kidney function after burn injury and resuscitation suited to in-human application. The mathematical model may provide an attractive platform to conduct non-clinical testing of burn resuscitation protocols and test new hypotheses on burn pathophysiology.


Internationally Educated Nurses in Transition in the United States: Challenges and Mediators.
International migration has doubled worldwide since 1970, and nurses are increasingly becoming a part of this trend. In 2008, approximately 5.6% of RN positions were filled by nurses educated in other countries. One of the critical issues is the transition of these immigrated nurses to the U.S. health care system and acculturation in a new society. Continuing education is necessary to promote adjustment and provide for a successful transition while ensuring quality patient care. The life patterns model provides a framework to describe the challenges and potential mediators in the transition process. J Contin Educ Nurs. 2017;48(3):139-144.


Deceased donor vein extension grafts for right living donor kidney transplantation.
In an effort to maximize living donor kidney utilization, we describe the use of deceased donor vein extension grafts for right-sided living donor kidneys and report our single-center experience using this technique. A retrospective review of kidney transplant recipients (KTR) who received a right living donor kidney with deceased donor vein extension graft. Recipient demographics, postoperative graft function, and surgical complications were reviewed. Living donor nephrectomies were performed laparoscopically. Vein grafts were obtained from recent deceased donor procurements. End-to-end anastomosis of the graft to the renal vein was performed prior to implantation. Thirty-eight KTR received a right kidney transplant with deceased donor extension grafts. The median recipient age and BMI were 53.0 years and 29.3 kg/m2 . Total 71% were male. Ninety-five percent of grafts displayed immediate graft function, with two recipients requiring temporary dialysis due to anaphylaxis from induction therapy. Median serum creatinine at two weeks was 1.6 mg/dL and at three months was 1.5 mg/dL. There were no graft thromboses. Utilization of deceased donor extension grafts for short right renal veins is a simple technique that expands the donor pool for living donor renal transplantation. Our experience resulted in no technical complications and excellent early graft function.


A prospective cohort study on the survival experience of under five children in rural western India.
To study the role of birth weight, nutrition, immunization and other medical as well as social factors in determining child survival. A prospective cohort study. 45 villages in Shirur Development Block in Pune District in Maharashtra. A cohort of 4129 children were followed from birth till 5 years of age. Weight and length/height of the child was measured at birth and at 3 monthly home visits. Information was also obtained on common childhood morbidities, immunization status and other bio-medical factors. Cause of death was ascertained by verbal autopsy. The neonatal, infant and underfive mortality was rates were estimated to be 37, 60 and 79 per 1000 live births, respectively. Diarrhea and ARI contributed to the major mortality burden. The Kaplan Meier Survival curve showed a sharp fall in the neonatal period, a less rapid decline in the post-neonatal period followed by a marginal fall in the post-infancy period till 5 years age. Girls had a better survival in the early neonatal period but the trend reversed in the late neonatal period. Normal birth weight children had better survival curves compared to low birth weight children. Survival improved with increasing birth order. Multivariate analysis revealed that birth weight, immunization status, and mother's and child's nutritional status influenced infant and under five mortality. Birth weight continues to exert its influence not only on survival/mortality in early life but even as late as 5 years of age. Strategies to improve child survival should include immunization and breastfeeding.


Strategic planning: it's worth the effort. Homework makes retreats work.
Medical groups that achieve superior operational and financial performance frequently have leaders who take time to hold strategic planning retreats. These gatherings allow practice leaders to address difficult issues such as expansion, compensation structure and governance--away from the workplace and facilitated by an outsider. The result: organizational direction that all leaders help shape and commit to.


Postmortem changes in the central nervous system and adrenal medulla of the heroin addicts.
This study describes the pathological changes in 20 heroin addicts (12 male and 8 female) autopsied 24 h after sudden death. The central nervous system (including the pituitary body) and the adrenal medulla were studied, along with those from age-matched controls who died from traffic accidents. Immunohistochemistry and histological (Hematoxylin and eosin) observation were performed. Some neuronal cells in every region of the CNS were positive for opioid receptors but these cells were most numerous in the hippocampus. Positive opioid fibers were most abundant in the basal ganglia region. Histopathology indicated coagulative changes of cytoplasm and dissolution of Nissl bodies of neuron. Edema of nerve fibers was frequently demonstrated. Pituitary body showed an evident decrease or even absence of basophils in the pars anterior. The adrenal medulla featured a down regulation of chromaffin granules. Degeneration of CNS neurons and fibers, alterations in hormonal and blood pressure regulation therefore would be the prime targets of heroin addiction in human subjects.


[Contingent negative variation and endogenous components of the evoked potential].
After having evoked the problems raised by the definition of the different endogenous components of evoked potentials, the author reviews the experimental data related to contingent negative variation (CNV), the processing negativity, the N200, P300 and the slow waves (SW1 and SW2). Their characteristics of amplitude, latency, duration, topography and their functional significance are examined. Then, the particular point of these waves' variability is pointed out, in relation to maturation, level of arousal and personality. Finally, the different theories which preside over their interpretation are reviewed.


Arthrodesis of the wrist with mini-fixators in infantile cerebral palsy.
The authors report the methods used and results obtained in the treatment of 12 cases of severe flexion deformity of the wrist in infantile cerebral palsy. They discuss the various surgical methods that have been proposed and describe an original method of wrist arthrodesis and its attendant advantages.


Hematologic and biosynthetic studies in homozygous hemoglobin Constant Spring.
The elongated alpha-globin chains of hemoglobin Constant Spring (alpha cs chain of HbCS ) are produced in low amounts such that the alpha cs-gene acts as a form of alpha-thalassemia; yet in the homozygous state the pathophysiological effects of this mutant are more severe than in the corresponding conditions that result from alpha-globin gene deletions. In studies designed to examine this discrepancy, we have demonstrated that a significant proportion of red cells produced in an HbCS homozygote has a much reduced red cell life span. Contrary to previous reports, we have been able to demonstrate the expected deficit in alpha-chain production in this condition and have shown that both the cessation of globin chain synthesis in vitro and the destruction of the excess beta-chains occur unusually rapidly. Comparison with various deletion forms of alpha-thalassemia suggests that, in terms of intracellular globin chain precipitates and free beta-chain pool, homozygous HbCS red cells more closely resemble those of HbH disease, with three of the four alpha-genes inactivated, than they do the more comparable alpha-thalassemia carriers with only two genes deleted.


Thyroid function and insulin secretion from the perfused pancreas in the rat.
The influence of thyroid function on the kinetics of glucose-induced insulin secretion from the isolated perfused rat pancreas has been studied. L-Thyroxine (L-T4) administration did not modify the immediate insulin secretory response of the perfused pancreas to glucose. L-Triiodothyronine (L-T3) treatment as well as propylthiouracil (PTU) treatment decreased the immediate insulin secretory response of the pancreas slightly. Only thyroidectomy (Tx) reduced the immediate secretory response of the pancreas significantly. L-T4 and L-T3 treatment inhibited the late phase of glucose-induced insulin secretion from the isolated perfused rat pancreas, whereas TX and PTU treatment resulted in increased insulin secretion. D-Thyroxine (D-T4) did not affect glucose-induced insulin release from the pancreas. Concomitantly, several parameters indicative of thyroid function were determined in these animals. When changes in body weight, rectal temperature, plasma glucose, plasma cholesterol, and plasma butanol-extractable iodine (BEI) in these rats were compared with the insulin secretory responses, it was evident that experimental hyperthyroidism results in decreased insulin release, whereas experimental hypothyroidism induces increased insulin secretion from the pancreas. The transitions from hypothyroid to euthyroid to hyperthyroid states are accompanied by a steady decrease in glucose-induced insulin release from the rat pancreas. Inhibition of glucose-induced insulin secretion from the pancreas is therefore a specific effect of thyroid hormones.


Reversible Anti-Spermatogenic Effect of Piperine on Epididymis and Seminal Vesicles of Albino Rats.
We have recently proved the interactions of piperine with androgen receptor and androgen binding protein. The present study was aimed to evaluate the antifertility effect of piperine on male albino rats after the treatment period i. e., after 60 days and withdrawal period i. e., after 120 days. Adult male rats were divided into 4 groups (n=12). Group I: Rats were given vehicle p.o i. e., 0.5% carboxy methyl cellulose (CMC) in normal saline daily for 60 days, Group II: Rats were treated with piperine suspended in 0.5% CMC at a dose of 10 mg/kg daily/60 days. Group III: Rats were treated with piperine suspended in 0.5% CMC at a dose of 10 mg/kg on every 4(th) day for 60 days. Group IV: Rats were treated with piperine suspended in 0.5% CMC at a dose of 10 mg/kg on every 7(th) day for 60 days. Piperine significantly altered the epididymal sperm count, motility, viability, weight of the epididymis, cauda, caput, corpus and seminal vesicles. It also exhibited negative impact on biochemical markers via decreasing epididymal sialic acid levels, seminal fructose content, epididymal anti-oxidant enzyme activities of super oxide dismutase (SOD), catalase (CAT) and by increasing the malondialdehyde content after the treatment period. Histopathological observations also supported the above findings. All the altered values were reinforced after the withdrawal period. From the results of this study, we can conclude that piperine has the potential to become a good lead for the reversible male oral contraceptive research.


Current status of the medical expenses for the treatment of arteriosclerosis obliterans in Japan.
We aimed to determine the current status of the medical expenses for the treatment of arteriosclerosis obliterans (ASO) and evaluate the cost effectiveness of the medical practices employed in ASO treatment in Japan. We performed a prospective observational study using 140 ASO patients. The cost of the medical practices comprised the costs of outpatient treatment, pharmacological agents, and hospitalization. To compare the average monthly costs, the patients were divided into preintervention, postintervention, or conservative-therapy groups. To compare the total costs and effectiveness of each treatment, the patients who had first visited our division during the study period were classified into surgery, endovascular-revascularization (EVR), or conservative-therapy groups. The adverse reactions of the 4 most popular agents for ASO were investigated, and bleeding events were assessed specifically. The average monthly costs for outpatient treatment and pharmacological agents were yen 168,002 in conservative cases, yen 149,871 in preoperation cases, and yen 128,527 in postoperation cases. The mean total costs were yen 5,407,950 in conservative cases, yen 7,375,290 in surgical cases, and yen 2,631,650 in EVR cases. The average change of the gauge in clinical status was 0.57 in conservative cases, 2.13 in surgical cases, and 2.25 in EVR cases. Warfarin induced more bleeding complications than the other agents. The costs of pharmacological agents represented much of the medical costs in any treatment groups.


Standards help to keep nurses and patients safe.
The proposed withdrawal of the standards for medicines management is potentially detrimental to nurses and patients. Medicines legislation is extremely complicated. The standards help practitioners understand what is legal and what is illegal, as well as legislation on licenced, off-licence and unlicensed medicines and the impact this could have on them.


[Survey on the current status of drinking water supply, latrines and the health knowledge of residents in the remote rural areas of several provinces of China].
A survey on the current status of drinking water supply, latrines and the health knowledge of residents in the remote rural areas of the southwest and northwest of China was reported. A stratified cluster sampling method was adopted in the survey. 83 poverty countries and 74,900 families were involved in the survey and four hundred thousands data were obtained by home visiting. The results showed that the coverage of rural latrines, sanitary latrines and safe night-soil disposal in the surveyed regions had reached 90.0%, 6.0% and 25.0% of populations respectively. The coverage of safe-drinking water was 57.6% of homes and no adequate supply of drinking water was 13.2% of homes; Many responders in the survey did not have the knowledge related to intestinal infectious diseases. There were 42.3% of them not knowing that night-soil was the source of infectious diseases, 56.2% of them not knowing that fly could spread infectious diseases and 70.0%-82.7% of them not knowing the ways of spreading intestinal infectious disease.


Negative Affect Regulation and Marijuana Use in College Students: Evaluating the Mediating Roles of Coping and Sleep Motives.
Negative affect regulation models suggest that marijuana may be used to reduce negative affect. Extant research has provided support for these models, indicating that specific motives for marijuana use, particularly coping motives (i.e., using to alleviate negative affects), mediate relations between affective vulnerabilities and marijuana outcomes. However, sleep motives (i.e., using to promote sleep) have been neglected from such models, despite their theoretical relevance. The present study tested two multiple mediation models in a large sample of marijuana-using college students (N = 1,453) to evaluate the indirect effects of coping and sleep motives in paths from depressive and anxiety symptoms to marijuana outcomes (use, consequences, and cannabis use disorder [CUD] symptoms). Both coping and sleep motives mediated the effects of depressive/anxiety symptoms on each marijuana variable. Moreover, significant double mediated effects were found, such that higher affective symptoms were associated with greater motives; which were associated with more marijuana use; which was related to more negative consequences and CUD symptoms. The findings provide support for sleep motives as a relevant pathway between affective vulnerabilities and marijuana outcomes. Additional research is needed to evaluate the potential benefits of interventions targeting specific marijuana motives.


Early cellular changes following cryosurgery of oral mucosa in hamsters.
Mitotic activity in the basal epithelial cells and mast cell degranulation have been studied as markers of early cellular change following experimental cryosurgery of hamster sublingual epithelium. It has been shown that mitotic activity initially increases, suggesting that freezing is a stimulus to cell division. Within a short time mitotic activity rapidly falls and this fall is preceded by a marked fall in the number of intact mast cells in the tissue. The timing of both events supports the view that early damage is apparent before vascular stasis intervenes.


Spin ice Thin Film: Surface Ordering, Emergent Square ice, and Strain Effects.
Motivated by recent realizations of Dy_{2}Ti_{2}O_{7} and Ho_{2}Ti_{2}O_{7} spin ice thin films, and more generally by the physics of confined gauge fields, we study a model spin ice thin film with surfaces perpendicular to the [001] cubic axis. The resulting open boundaries make half of the bonds on the interfaces inequivalent. By tuning the strength of these inequivalent "orphan" bonds, dipolar interactions induce a surface ordering equivalent to a two-dimensional crystallization of magnetic surface charges. This surface ordering may also be expected on the surfaces of bulk crystals. For ultrathin films made of one cubic unit cell, once the surfaces have ordered, a square ice phase is stabilized over a finite temperature window. The square ice degeneracy is lifted at lower temperature and the system orders in analogy with the well-known F transition of the 6-vertex model. To conclude, we consider the addition of strain effects, a possible consequence of interface mismatches at the film-substrate interface. Our simulations qualitatively confirm that strain can lead to a smooth loss of Pauling entropy upon cooling, as observed in recent experiments on Dy_{2}Ti_{2}O_{7} films.


Risk factors for pressure ulcer recurrence following surgical reconstruction: A cross-sectional retrospective analysis.
Many studies on the recurrence of pressure ulcers after surgical reconstruction have focused on surgical techniques and socioeconomic factors. Herein, we aimed to identify the risk factors of the associated comorbidities for pressure ulcer recurrence. We enrolled 147 patients who underwent pressure ulcer reconstruction and were followed up for more than three years. The recurrence of pressure ulcers was defined as recurrent pressure ulcers with stage 3/4 pressure ulcers. We reviewed and analyzed systematic records of medical histories, including sex, age, associated comorbidities such as spinal cord injury (SCI), diabetes mellitus (DM), coronary artery disease, cerebral vascular accident, end-stage renal disease, scoliosis, dementia, Parkinson's disease, psychosis, autoimmune diseases, hip surgery, and locations of the primary pressure ulcer. Patients with recurrent pressure ulcers were younger than those without. Patients with SCI and scoliosis had higher odds, while those with Parkinson's disease had lower odds of recurrence of pressure ulcers than those without these comorbidities. Moreover, the decision tree algorithm identified that SCI, DM, and age < 34 years could be risk factor classifiers for predicting recurrent pressure ulcers. This study demonstrated that age and SCI are the two most important risk factors associated with recurrent pressure ulcers following surgical reconstruction.


Hereditary spastic paraplegia with recessive trait caused by mutation in KLC4 gene.
We report an association between a new causative gene and spastic paraplegia, which is a genetically heterogeneous disorder. Clinical phenotyping of one consanguineous family followed by combined homozygosity mapping and whole-exome sequencing analysis. Three patients from the same family shared common features of progressive complicated spastic paraplegia. They shared a single homozygous stretch area on chromosome 6. Whole-exome sequencing revealed a homozygous mutation (c.853_871del19) in the gene coding the kinesin light chain 4 protein (KLC4). Meanwhile, the unaffected parents and two siblings were heterozygous and one sibling was homozygous wild type. The 19 bp deletion in exon 6 generates a stop codon and thus a truncated messenger RNA and protein. The association of a KLC4 mutation with spastic paraplegia identifies a new locus for the disease.


The Future of Migraine Prevention.
Barring unforeseen circumstances, we anticipate the arrival of the first mechanism-specific class of molecules for migraine prevention in 2018. Despite many ground-breaking advances in the field over the last several years, these agents, broadly identified as calcitonin gene-related peptide-based pharmaceuticals, have captured the imagination and attention of the lay press and much of the headache community. This paper will address the factors, both class-specific and systems-based, that are likely to affect the launch, access, compliance, and adherence related to this new class, as well as attempt to place these novel medications in context of the current state and anticipated changes in headache medicine.


Neurotransmitter deficits from frontotemporal lobar degeneration.
Frontotemporal lobar degeneration causes a spectrum of complex degenerative disorders including frontotemporal dementia, progressive supranuclear palsy and corticobasal syndrome, each of which is associated with changes in the principal neurotransmitter systems. We review the evidence for these neurochemical changes and propose that they contribute to symptomatology of frontotemporal lobar degeneration, over and above neuronal loss and atrophy. Despite the development of disease-modifying therapies, aiming to slow neuropathological progression, it remains important to advance symptomatic treatments to reduce the disease burden and improve patients' and carers' quality of life. We propose that targeting the selective deficiencies in neurotransmitter systems, including dopamine, noradrenaline, serotonin, acetylcholine, glutamate and gamma-aminobutyric acid is an important strategy towards this goal. We summarize the current evidence-base for pharmacological treatments and suggest strategies to improve the development of new, effective pharmacological treatments.


The clinical effect of uterine hyperflexion and cervical elongation in cases of pelviscopic hysterectomy.
In a retrospective study of women who had undergone pelviscopic hysterectomies in the last 2 years, we focused on postoperative cyclic spotting. Preoperatively, a regular, cyclic menstruation and a premenopausal sexual hormone constellation were common to all patients. In the first group (n = 29), spotting occurred only in association with two uterine anatomical varieties: uterine hyperflexion and cervical elongation. The second group (n = 18), in which intraoperative internal electrocoagulation of the residual cervical envelope was performed, no spotting occurred despite the presence of uterine hyperflexion and cervical elongation. This procedure prevents the occurrence of postoperative spotting in cases of uterine anatomical varieties.


Clinical judgment predicts culture results in upper respiratory tract infections.
We wanted to describe the natural history, familial transmission, microbiology, and accuracy of clinical judgment of potential pathogens of respiratory tract infections in a community family practice. The study was a prospective case series in which consecutive patients requesting treatment for respiratory tract infections were evaluated after nurse triage during 3 fall-spring months in a solo family practice in suburban Cleveland, Ohio. According to the physician's usual practice, patients were classified into high-, medium-, and low-risk groups for bacterial illness based on their clinical signs and symptoms. Cultures were performed and sensitivities were determined for pathogens from the infected throat, nasopharynx, conjunctiva, or other sites. Patient symptoms and well-being were scored at the initial visit and at 3, 7 and 14 days later. There were 111 illness episodes in 86 patients; 94% had cultures taken, of which 38% grew a potentially pathogenic bacteria, most commonly group A streptococci, Branhamella catarrhalis or Staphylococcus aureus. The physician's judgment of bacterial infection was associated (P < .001) with having a positive culture (sensitivity 53%, specificity 78%, positive and negative predictive values 60% and 73%, respectively). A positive culture was associated with 2 of 16 signs or symptoms: purulent discharge from any site or a red swollen eye. There was no association of treatment status with clinical outcomes during 2 weeks of follow-up observation. Infection with a potentially pathogenic bacteria is difficult to determine solely by clinical signs and symptoms, but clinical judgment is associated with positive culture results. The effect of selective treatment of upper respiratory tract infection based on clinical signs and symptoms and patient and family culture results remains to be determined, but using clinical judgment could result in more selective antibiotic use than found in current practice patterns.


Embryo and larval biology of the deep-sea octocoral Dentomuricea aff. meteor under different temperature regimes.
Deep-sea octocorals are common habitat-formers in deep-sea ecosystems, however, our knowledge on their early life history stages is extremely limited. The present study focuses on the early life history of the species Dentomuricea aff. meteor, a common deep-sea octocoral in the Azores. The objective was to describe the embryo and larval biology of the target species under two temperature regimes, corresponding to the minimum and maximum temperatures in its natural environment during the spawning season. At temperature of 13 ±0.5 °C, embryos of the species reached the planula stage after 96h and displayed a median survival of 11 days. Planulae displayed swimming only after stimulation, swimming speed was 0.24 ±0.16 mm s-1 and increased slightly but significantly with time. Under a higher temperature (15 °C ±0.5 °C) embryos reached the planula stage 24 h earlier (after 72 h), displayed a median survival of 16 days and had significantly higher swimming speed (0.3 ±0.27 mm s-1). Although the differences in survival were not statistically significant, our results highlight how small changes in temperature can affect embryo and larval characteristics with potential cascading effects in larval dispersal and success. In both temperatures, settlement rates were low and metamorphosis occurred even without settlement. Such information is rarely available for deep-sea corals, although essential to achieve a better understanding of dispersal, connectivity and biogeographical patterns of benthic species.


Differential expression of natural antisense transcripts during liver development in embryonic mice.
The mature adult liver is a metabolizing and synthesizing organ consisting of hepatic lobules. The liver development during fetal stages is induced by the interaction between hepatoblast cells derived from the endoderm and stellate cells and/or endothelial cells derived from the mesoderm. Recently, the association of non-coding RNAs, such as microRNAs, in the liver development process has been reported. In the present study, the gene expression changes were investigated of natural antisense transcripts (NATs), a type of non-coding RNA, during the liver development using livers from embryonic day (E) 14, E17, E19 and newborn (NB). The upregulated NATs of 87 genes and the downregulated NATs of 26 genes were identified when the expression was >5.0-fold up/downregulated NATs at E17, E19 or NB compared to those at E14, as examined by microarray analysis. Among these NATs, strand-specific reverse transcription-quantitative polymerase chain reaction analyses validated that the NAT expression of Fga, Fgb, Fgg, F2, Apoa1, Fabp1, C3 and Proc, which have metabolic and synthesizing functions in the adult liver, increased, whereas the NAT expression of Ermap and Tfrc, which function in the hematopoiesis, decreased during the developmental stages. These results indicate that the differential expression of several NATs is induced during the process of liver development, suggesting that these NATs may be involved in the regulation of gene expression and functional conversion from a hematopoietic to a metabolic organ in the developmental stages of the liver.


Evaluation of highly buffered low-calcium solution for long-term preservation of the heart. Comparison with University of Wisconsin solution.
Myocardial preservation for prolonged ischemia has traditionally centered around deep hypothermia with metabolic arrest. This approach is limited in tolerable ischemic time by the state of energy reserves at the onset of ischemia, because anaerobic glycolysis during ischemia is limited by end-product accumulation (lactate, alanine, and H+). In this study we evaluated a novel preservation solution containing the basic amino acid histidine to buffer H+, glucose as substrate, and low sodium and calcium concentrations to mimic the intracellular ionic environment. Isolated rabbit hearts were subjected to hypothermic ischemia for 8 and 16 hours at 4 degrees and 21 degrees C followed by reperfusion. The buffered solution was compared to University of Wisconsin solution (high potassium). Intracellular pH was maintained at preischemic levels in the buffered solution hearts at 21 degrees C, and this was associated with better preservation of high energy stores and recovery of contractile function. Developed pressure recovered to 90% +/- 3% of preischemic values after 16 hours of 21 degrees C ischemia with the buffered solution as compared with 79% +/- 2% in the University of Wisconsin group at 4 degrees C (contracture occurred in the University of Wisconsin hearts at 21 degrees C). The optimal temperature in the buffered solution hearts was 13 degrees C, and with this temperature acceptable recovery of contractile function was seen after 24 hours of ischemia. On the basis of these results, we conclude that promoting anaerobic glycolysis during ischemia achieves superior prolonged preservation of energetic and contractile function of the heart.


Motor imagery based brain computer interface using transform domain features.
Brain Computer Interface (BCI) is a channel of communication between the human brain and an external device through brain electrical activity. In this paper, we extracted different features to boost the classification accuracy as well as the mutual information of BCI systems. The extracted features include the magnitude of the discrete Fourier transform and the wavelet coefficients for the EEG signals in addition to distance series values and invariant moments calculated for the reconstructed phase space of the EEG measurements. Different preprocessing, feature selection, and classification schemes were utilized to evaluate the performance of the proposed system for dataset III from BCI competition II. The maximum accuracy achieved was 90.7% while the maximum mutual information was 0.76 bit obtained using the distance series features.


Photoprotective effect of Pothomorphe umbellata root extract against ultraviolet radiation induced chronic skin damage in the hairless mouse.
In this study we evaluated the activity of Pothomorphe umbellata root extract on hairless mice chronically exposed to UVB radiation (76.5 mJ/cm(2), 4 days per week for 22 weeks). Mouse dorsal surfaces were treated topically with 20 mg/cm(2) of a carbomer 940 gel (vehicle) with or without P. umbellata root extract to a final concentration of 0.1%, for 2 h before irradiation. Another irradiated group received no topical treatment. A fourth group received no treatment and was not irradiated. Visible skin wrinkling was evaluated using a scale ranging from 0 to 4, where 0 corresponds to no skin modification, and 4 to the maximum visual skin alteration observed in our experiments. Histological measurements were carried out on standard haematoxylin & eosin stained sections. The mean distances between the outermost surface of the epidermis (excluding the stratum corneum) and the dermal-epidermal junction were determined by morphometric analysis. These distances were statistically increased in the irradiated control groups when compared to the nonirradiated control group and to the irradiated group using P. umbellata root extract. These data demonstrate that P. umbellata may be successfully used as a topical skin-protecting agent against the deleterious effects of UV radiation.


Allergic reactions to local anesthetics.
The majority of adverse reactions to local anesthetics are due to high plasma levels from excessive quantities of a drug. These are often blamed on idiosyncrasy, sensitivity, or allergy. The incidence of reactions due to allergy to local anesthetics is low compared to that with other drugs. Allergic reactions may be systemic or local. More than 80% of reactions are cell mediated, resulting in contact dermatitis. The remainder are caused by circulating antibodies that give rise to systemic anaphylaxis. Acute anaphylactic reactions are rare but invariably fatal unless promptly treated. Localized systemic anaphylactic reactions manifested by urticaria, laryngeal edema, and extrinsic asthma are less serious and amenable to treatment. There is no foolproof test for screening of susceptible persons. The intradermal test is of no value for detecting possible systemic sensitivity. The patch test is useful for detecting contact allergy. Systemic reactions are treated with epinephrine, antihistamines, and steroids. Contact dermatitis responds to topical steroids.


Beta-adrenergic receptors in the lateral nucleus of the amygdala contribute to the acquisition but not the consolidation of auditory fear conditioning.
Beta-adrenergic receptors (βARs) have long been associated with fear disorders and with learning and memory. However, the contribution of these receptors to Pavlovian fear conditioning, a leading behavioral model for studying fear learning and memory, is still poorly understood. The aim of this study was to investigate the involvement of βAR activation in the acquisition, consolidation and expression of fear conditioning. We focused on manipulations of βARs in the lateral nucleus of the amygdala (LA) because of the well-established contribution of this area to fear conditioning. Specifically, we tested the effects of intra-LA microinfusions of the βAR antagonist, propranolol, on learning and memory for auditory Pavlovian fear conditioning in rats. Pre-training propranolol infusions disrupted the initial acquisition, short-term memory (STM), and long-term memory (LTM) for fear conditioning, but infusions immediately after training had no effect. Further, infusion of propranolol prior to testing fear responses did not affect fear memory expression. These findings indicate that amygdala βARs are important for the acquisition but not the consolidation of fear conditioning.